Irritability

Alternative Names: Inconsolability

Irritability is an excessive response to stimuli.

Considerations

The term "irritability" is used for infants and young children who, when ill, are especially fussy, whiny, and fretful, despite attempts at comforting and soothing them.

Parents are usually very aware of their child's normal behavior and may pick up early changes that the health care provider wouldn't notice. This can help diagnose illness early.

Causes of Irritability

Irritability can be a very early sign of serious problems. Although irritability is not a symptom of any specific illness, it should arouse suspicion in the parent that something might be wrong with the child, even though there may not yet be other symptoms.

Causes of irritability include:

• Alcohol or drug withdrawal state
• Autism spectrum disorders
• Cancer
• Colic in infants
• Congenital infections
• Diabetes or other metabolic disease
• Drug reaction
• Ear infection
• Encephalitis
• Fracture, sprain, or other bone, joint, or tissue injury
• Headache (migraine or other)
• Head trauma
• Hydrocephalus
• Hypoglycemia
• Intestinal obstruction
• Intracranial bleeding or abscess
• Iron deficiency anemia
• Lead poisoning
• Meningitis or other serious infection
• Milk intolerance
• Nutritional deficiencies
• Pinworm
• Psychiatric illnesses
• Sleep disorders
• Tay-Sachs or other genetic disease
• Teething
• Viral infection

Home Care

Attempt to soothe the child with usual measures -- rocking, cuddling, or whatever the child normally finds soothing. If the child cannot be consoled, consult your health care provider.

Watch the child for other symptoms such as:

• Abdominal pain
• Fever
• Poor appetite
• Rash
• Vomiting

When to Contact a Health Professional

Contact your health care provider if your child is irritable or inconsolable, with or without other symptoms.

The health care provider will take a medical history and perform a physical examination. Tests may include:

• Blood culture
• Complete blood count
• Electrolyte analysis

Medical history questions documenting irritability in detail may include:

• How irritable is the child?
• Does the irritability persist?
• How does the child normally eat (how often, how much)?
• How is the child eating now?
• How often does the child normally have bowel movements?
• Does the child have problems with diarrhea or constipation?
• What other symptoms does the child have?
• Is there any fever, confusion, or pain?

After seeing your health care provider, you may want to add a diagnosis related to irritability to your personal medical record.

McCarthy PL. Evaluation of the sick child in the office and clinic. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 60.

Central nervous system

Review Date: 11/7/2009
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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